Diagnostic Study Of Transrectal Ultrasonography In The Preoperative Staging Of Rectal Carcinoma

Objective:1)Discussing the accuracy and limitations of transrectal ultrasound (TRUS) in Preoperative stage of rectal cancinoma.2Evaluating of the relationship between transrectal ultrasound (TRUS) in preoperative stage of rectal carcinoma and serum carcinoembryonic antigen(CEA).Material and methods:52 cases of cancer patient were selected from February 2008 to November 2008.and examined preoperatively using transrectal ultrasound in a week,the tumor location,the size,the shape,the eeho patten,the blood flow and the depth of invasion of rectal tumor were observed.The results of TRUS were correlated with operative and pathologic findings according to the TNM classification , and serum carcinoembryonic antigen (CEA) level,were exclused other malignant disease and in the radiotherapy and chemotherapy.Were not performed preoperatively in 52 patients.Results:1) TRUS of 52 cases of a particular disease overall accuracy in T staging was 76.9%.The accuracy of TRUS for T1,T2,T3 and T4 carcinoma was respectively 75%,68.7%,72.7%,100%.2) There were no significant differences of accuracy between various tumor location (x2=0.068,P=0.795).3) The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TRUS in lymph node metastasis were 70%,72.7%,71%,77.8%,64%,respectively.4) Serum CEA level was closely correlative with the invasive degree of the rectal wall and the lymph node metastasis,The accuracy rate of preoperative stage of rectal carcinoma was high of 88% when TRUS was combined with the serum CEA level. Conclusion:1) The TRUS has become an important imaging tool in the preoperative assessment of the depth of tumor invasion and lymph node metastasis of rectal carcinoma.2) Rectal stenosis and inflammation caused by carcinoma may decrease the accuracy of TRUS.3) The preoperative serum CEA level has the reference value in TRUS preoperative stage of rectal carcinoma. It could raise the diagnostic accuracy rate of preoperative staging of rectal carcinoma when TRUS is combined with the serum CEA level.